| Doctor Name: | HABIB SANOGO |
| NPI Number: | 1013309467 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MED. |
| License Number: | LPCCCA00216628 |
| Business Practice Address: | 308 Barnes Rd Williamstown, KY - 410979483 |
| Business Phone Number: | 8593313292 |
| Business Fax Number: | 8595782864 |
| Mailing Address: | 502 Farrell Dr, COVINGTON |
| State: | KY |
| Postal Code: | 410113717 |
| Phone Number: | 8595783204 |
| Fax Number: | 8595783273 |
| NPI Enumeration Date: | 02/23/2015 |
| NPI Last Update Date: | 02/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPCCCA00216628 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |